Guidelines
Side Chain Reference Tool

Side Chain Reference Tool

AHSM Penicillin/Cephalosporin Allergy Pharmacy Protocol

Penicillin Ordered

  • Contact prescriber for alternative or desensitization/challenge if PCN is necessary for Treatment

Cephalosporin Ordered

  • May use cephalosporin with dissimilar side-chain

Penicillin Ordered

  • Contact prescriber for alternative or desensitization/challenge if PCN is necessary for Treatment

Cephalosporin Ordered

  • May use cephalosporin

Penicillin Ordered

  • May use penicillin with dissimilar side chain

Cephalosporin Ordered

  • May use cephalosporin with dissimilar side-chain

Notes

  • Cefazolin has no like side-chains with any PCN or cephalosporins.
  • Cefazolin plus metronidazole (over 30 min) may be substituted for cefoxitin in penicillin allergic (IgE) patients

Antibiotic Side Chain Similarity

  • Ampicillin 6
  • Cefaclor 6/7
  • Cefadroxil 6/7
  • Cefprozil 6/7
  • Cephalexin 6/7
  • Amoxicillin 6
  • Cefaclor 6/7
  • Cefadroxil 6/7
  • Cefprozil 6/7
  • Cephalexin 6/7
  • Amoxicillin 6/7
  • Ampicillin 6/7
  • Cefadroxil 7
  • Cefprozil 7
  • Cephalexin 7
  • Amoxicillin 6/7
  • Ampicillin 6/7
  • Cefaclor 7
  • Cefprozil 7
  • Cephalexin 3,7
  • Cefixime 3
  • Cefotaxime 7
  • Cefpodoxime 7
  • Ceftizoxime 7
  • Ceftriaxone 7
  • Cefdinir 3
  • Cefepime 7
  • Cefpodoxime 7
  • Ceftizoxime 7
  • Ceftriaxone 7
  • No side chain similarities reported
  • Cefuroxime 3
  • Penicillin G 6/7
  • Cefepime 7
  • Cefotaxime 7
  • Ceftizoxime 7
  • Ceftriaxone 7
  • Amoxicillin 6/7
  • Ampicillin 6/7
  • Cefaclor 7
  • Cefadroxil 7
  • Cephalexin 7
  • No side chain similarities reported
  • Ceftizoxime 3
  • Cefepime 7
  • Cefotaxime 7
  • Cefopodoxime 7
  • Ceftibuten 3
  • Ceftriaxone 7
  • Cefepime 7
  • Cefotaxime 7
  • Cefopodoxime 7
  • Ceftizoxime 7
  • Cefoxitin 3
  • Amoxicillin 6/7
  • Ampicillin 6/7
  • Cefaclor 7
  • Cefadroxil 3, 7
  • Cefprozil 7
  • Cefoxitin 6/7

Additional Information

J Am Pharm Assoc. 2008;48:530–540.

For international and off-market cephalosporins, refer to full chart in original article